LETTER
Minocycline-induced Pneumonia
Allan J. Bridges
1 May 1993 | Volume 118 Issue 9 | Pages 749-750
TO THE EDITOR:
We have reported a case [1] of minocycline-induced pneumonitis similar to that reported by Guillon and colleagues [2]. After 4 months of minocycline therapy for acne, a young woman developed bilateral pulmonary infiltrates and fever. Bronchoalveolar lavage specimens obtained while the patient continued minocycline therapy showed macrophages, 31%; neutrophils, 60%; eosinophils, 5%; and bronchial epithelial cells, 4%; with a total cell count of 2000. We did not find evidence of bronchoalveolar lavage lymphocytosis. Flow cytometry was not done.
Within 2 weeks of discontinuing minocycline therapy, the symptoms and infiltrates resolved. Simultaneously, the patient developed erythema nodosum.
It was our impression that the patient developed a hypersensitivity pneumonitis characterized by neutrophilic and eosinophilic pneumonitis, which suggested pulmonary infiltration with eosinophilia similar to other reports [3, 4]. The immune response of the lungs is pluripotential. Possibly the length of exposure to the drug or the immunogenetic background of our patient led to different cellular responses. In the case presented by Guillon and colleagues [2], the cellular immune responses to minocycline exposure were clear.
1. Bridges AJ, Graziano FM, Calhoun W, Reizner GT. Hyperpigmentation, neutrophilic alveolitis, and erythema nodosum resulting from minocycline. J Am Acad Dermatol. 1990; 22:959-62.
2. Guillon JM, Joly P, Autran B, Denis M, Akoun G, Debre P, et al. Minocycline-induced cell-mediated hypersensitivity pneumonitis. Ann Intern Med. 1992; 117:476-81.
3. Valcke Y, Pauwels R, Van Der Straeten M. Bronchoalveolar lavage in active hypersensitivity pneumonitis caused by sulfasalazine. Chest. 1987; 92:572-3.
4. Gall JM, Villanova JL, Mayos M. Febarbamate-induced pulmonary eosinophilia: a case report. Respiration. 1986; 49:231-4.
About Letters
The Editors welcome submissions for possible publication in the Letters section. Authors of letters should:
•Include no more than 300 words of text, three authors, and five references
•Type with double-spacing
•Send three copies of the letter, an authors' form signed by all authors, and a cover letter describing any conflicts of interest related to the contents of the letter.
Letters commenting on an Annals article will be considered if they are received within 6 weeks of the time the article was published. Only some of the letters received can be published. Published letters are edited and may be shortened; tables and figures are included only selectively. Authors will be notified that the letter has been received. If the letter is selected for publication, the author will be notified about 3 weeks before the publication date. Unpublished letters cannot be returned.
Annals welcomes electronically submitted letters.
Top
References
Article
